Inpatient surgical procedures per year per 100 000Indicator code: E992932.T This indicator shares the definition with the parent indicator \"Total number of inpatient surgical procedures per year\".

OECD definition adopted. All invasive therapies performed as in-patient surgery, where in-patient surgery is defined as a surgical operation or procedure that is performed with an overnight stay in an in-patient institution. (OECD Health Data 2000, OECD, Paris, 2000)._

Source: Federal Public Service of Public Health, Food Chain Safety and Environment. Health CareFacilities Organization (DG1), Minimal Clinical Data for 2007 is provisional.

Cyprus

Public sector general hospitals only.

Czechia

Source: Institute of Health Information and Statistics of CR (IHIS CR). Survey on bed resources ofhealth establishments and their exploitation. Coverage: Data relates to number of operationsperformed in operation theatres in bed care departments of hospitals and specialized therapeuticinstitutes.

Estonia

Since 2003 NCSP (NOMESCO Classification of Surgical Procedures), is used, chapters A-H, J-N, P, Q,Y. In order to provide more comparable data with previous years, the main surgical procedure hasbeen used for counting the number of operations. Source: annual reporting, National Institute forHealth Development.

Source: National Centre for Disease Control and Public Health of Georgia (NCDC) (http://www.ncdc.ge)

Germany

Number of in-patients in hospitals undergoing surgical procedures and stay over at least one night.Included are cases of death, excluded are day-cases. Counted is the number of patients undergoingprocedures according to OPS, no matter how many operations were accomplished. Each patient countedone time. This includes diagnostic procedures as well. In 1993 the coverage of hospitals was 96.2%;in 1994 it was 99.0% and from 1995 it was virtually 100%. Source: Federal Statistical Office,Hospital statistics - diagnostic data of the hospital patients.

Hungary

Source until 2003: Center for Health Care Information (GYOGYINFOK). The data is the case number ofdepartment discharges. Source from 2004: National Institute for Strategic Health Research (ESKI).

Iceland

The Directorate of Health. Data from 1998-2009 corrected. This was based on OECD shortlist forinpatient surgery but now the numbers represent all procedures performed as in-patient surgery.Furthermore, all procedures per stay are counted and not only main/principal procedures (this is inaccordance with OECD and Eurostat definitions).

Ireland

Source: The data presented are derived from the HIPE (Hospital In-Patient Enquiry) data set, whichrecords data on discharges from all publicly funded acute hospitals. The Economic and SocialResearch Institute (ESRI) is contracted by the Health Service Executive (HSE) to manage the HIPEsystem. See http://www.esri.ie/health_information/hipe/.

Coverage: HIPE data covers all in-patients and day cases receiving curative and rehabilitative care inpublicly funded acute hospitals in the State. HIPE data do not include private hospitals. It isestimated that in excess of 10% of all hospital activity in Ireland is undertaken in privatehospitals. The data coverage in HIPE exceeds 96%, i.e. overall approximately 4% of activity in publicly fundedacute general hospitals is missing from HIPE.

The definition of day case is a patient who is formally admitted with the intention of dischargingthe patient on the same day, and where the patient is in fact discharged as scheduled (i.e.excluding deaths and emergency transfers) on the same day. All other patients, including those whoare admitted or discharged as emergencies on the same day, are considered in-patients. In accordancewith WHO guidelines, day cases have been excluded from the data presented for discharges. Thisdefinition is the same as that used in submission of data to the OECD and Eurostat. This ensuresconsistency in HIPE data reported by international organisations.

Deviation from the definition: The data on surgical procedures for all years are based on thenumber of inpatients with a surgical DRG (Diagnosis Related Group). As DRG designation is primarilybased on the main diagnosis and main procedure (and other factors such as age), the data onlyinclude the main procedure. Prior to 2005, HIPE data was coded in ICD-9-CM. The ICD-9-CM classification categorized everyprocedure as an OR procedure or non-OR procedure. From 2005, HIPE data is coded using ICD-10-AM (theAustralian Modification of ICD-10 incorporating the Australian Classification of HealthInterventions). However in ICD-10-AM there is no comprehensive list of OR or non-OR procedures. Forthis reason, the surgical DRG methodology is used for all years.

Break in time series: Data for 1994-2004 were classified using ICD-9-CM. All HIPE discharges from 2005 are now codedusing ICD-10-AM (the Australian Modification of ICD-10 incorporating the Australian Classificationof Health Interventions). The change from ICD-9-CM to ICD-10-AM has resulted in some minor changesin the classification of diagnoses and procedures, and a change from HCFA DRGs to Australian RefinedDRGs (ARDRGs). For more information on the introduction of ICD-10-AM in Ireland seehttp://www.esri.ie/health_information/hipe/clinical_coding/classifications/.

Israel

Inpatient procedures in acute care hospitals. Source until 1990: based on Diagnostic statistics ofhospitalization, Central Bureau of Statistics and Ministry of Health. Since 1993 based on theNational Hospital Discharges Database, Department of Health Information, Ministry of Health. Daytreatment cases and hospitalisations without overnight stay are not included since 1994.

Italy

Source: Ministry of Health. Data derived from S.D.O. (Scheda Dimissione Ospedaliera) and refer toall public and private hospitals. Clinical data gathered in the hospital discharges database arecoded with the following versions: until 2005 with ICD9-CM version 1997, from 2006 to 2008 withICD9-CM version 2002, since 2009 with the ICD9-CM version 2007.

Lithuania

Source: Up to 2000: LHIC (Lithuanian Health Information Centre) annual report data. From 2001: HIHIC data from annual reports and Compulsory Health Insurance Database (for day cases). Coverage: Up to 2000: including day cases. From 2001: excluding day cases.

Montenegro

Data are not available.

Netherlands

Source: Hospital Discharge Register (HDR) of Dutch Hospital Data. From 2005 onwards the HDR in theNetherlands suffers from a substantial degree of non-response, especially for the reporting ofsurgical procedures. Therefore we raised the figures by imputation of data for the non-respondinghospitals. This results in less accuracy of the figures. The inaccuracy is higher for surgicalprocedures than for hospital diagnoses because from 2005 onwards some hospitals do registerdiagnoses but do not report procedures. In 2004, for only 1% of the discharges did the surgicalprocedures have to be imputed. In 2005 it was 13%, in 2006 it was 26% and in 2007 it was 31%. Thefigures include the surgical treatments in Dutch hospitals to non-residents of the Netherlands.

Portugal

Source of data: National Statistical Institute Coverage: National

Spain

Source up to 1996: National Statistics Institute and Ministry of Health and Consumer Affairs.Statistics on Health Establishments Providing Inpatient Care. Source from 1996: Ministry of Healthand Consumer Affairs. (www.msc.es/)

Sweden

Source: National Patient Register NBHW.

Switzerland

The data is restricted to inpatient cases (exclusion of day cases). Source of data: FSO FederalStatistical Office, Neuchatel; Medical Statistics of Hospitals; yearly census. Coverage: Full coverage of hospitals; sufficient (nearly full) coverage of inpatient and day casessince 2002. Due to a modification of the legislation, day cases are not collected in 2009 anymore. Deviation from the definition: Estimation method: Discharges without a valid ICD-code are not accounted for (negligible). Break in time series: The gradual change of diagnosis classification since 2008 from ICD-10 WHO toICD-10 GM (German Modification) may lead to breaks for some categories.

Turkey

Source: General Directorate of Curative Services. Method: Total surgical interventions also includethe number of daily surgical interventions.

Coverage: Data relates to NHS activity or NHS commissioned activity in the independent sector.Includes any mention of operation procedure between OPCS codes 'A00' and 'X97' but not between 'O11'and 'O14' (site codes). Years are based on episode end year. Scotland - 2010 data are affected by data submission issues that we have encountered, so theyshould be regarded as provisional and potentially incomplete.ÿ We are also aware of a specific hospital where the SMR01 returns from November 2010 onwards weremissing their operation codes.ÿ This will also be a factor.

Finally, from 1 April 2008, it was no longer mandatory to record 'non-operative'interventions/procedures (such as imaging, injections, infusions, x-rays, etc) unless the patient isspecifically admitted for this purpose. Therefore this will also impact on figures for 2008onwards.ÿ For further details about this please refer to the Clinical Coding Guidelines (March 08No.22) (page 6).

Deviation from the Definition: There is no agreed list of OPCS procedure codes from which the UKcan accurately identify surgical procedures. As such the data provided is for total inpatientprocedures.

Break in Time Series: Data from 2000 onwards is not comparable with data from prior to this. Thisis due to work conducted to improve compliance with definitions and consistency of methodologiesacross the four parts of the UK. 2010 - All data is financial year data with the exception of Scotland whose data is calendar year.